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83-year-old mrs. lu went to xi'an xincheng tuanyuan stomatological hospital to check her lower teeth. in august, she made a plan to have her lower teeth extracted and made dentures. she paid 5,000 yuan on the spot. in september, she was accompanied by her 90-year-old wife when she went to have a dental appointment. the hospital changed the treatment plan. the old lady had all her teeth extracted and implanted. the six normally functional upper teeth were also extracted at once, leaving only two wisdom teeth in her mouth.

tuanyuan dental stated that the hospital does not need to notify family members and there is no legal requirement for children to sign for surgery.

>>luck or a trap?

tuanyuan dental has set up a stall in the community. if you go to the dentist the next day, you will "win", but you have to pay on the spot.

ms. hu's parents live in fengcheng road, xi'an, shaanxi province. on august 21, she saw xi'an xincheng tuanyuan dental hospital setting up a stall in the community to promote. "thinking about it afterwards, the person setting up the stall looked too much like a child care provider." ms. hu said that her father was 90 years old, my mother, ms. lu, is 83 years old. her upper teeth are still usable, but there are two lower teeth left. they are loose and she wants to have her mandibular dentures redone. after consultation, "sun, who runs the stall, said that the hospital happened to have a discount the next day. let's go to the hospital."

on august 22, ms. hu and her parents came to tuanyuan dental hospital and were picked up and dropped off by sun. when we arrived at the hospital, "sun took us to the lottery and gave us three lottery tickets." ms. hu said that in three consecutive rounds, three lottery tickets won one after another. she first won a bag of rice, and her parents won two more. the coupons, "one of them says '10,000 yuan', and you can get four european brand teeth for free with an implant; one of them says you can get 1,000 yuan off other projects. with so many people, we are the only ones who have won big prizes one after another? do you think we are lucky?" , it was later discovered that it was a trap.”

on the same day, after ms. lu took an oral ct scan, the doctor came up with a treatment plan and decided to extract two lower teeth to make dentures. ms. hu said that the price of removable dentures for lower teeth is 6,800 yuan, and the doctor discounted it to 6,000 yuan. "we said there was still 1,000 yuan left in the lottery. they asked the leader for instructions. after a while, they came back and said that the 1,000 yuan coupon could be used, but the fee must be paid on the same day. , otherwise it will be invalid.”

ms. hu said that she paid 5,000 yuan for the dentures on site, and the hospital said she could go for treatment at any time later. “we didn’t consider dental implants, otherwise we would definitely have used the 10,000 yuan coupon.”

the old lady paid nt$5,000 to make a plan for dentures, but when her children were away, she had to pay nt$44,000 for dental implants.

on september 19, my mother, ms. lu, went to xi'an xincheng tuanyuan stomatological hospital to get removable lower teeth. "it was decided in the early stage that we were going to get lower dentures. i had something to do and didn't go there that day. unexpectedly, the couple went by themselves, and the hospital took care of them. my mother had all her teeth extracted and had 12 dental implants made, and she had to pay another 44,000 yuan. "ms. hu said that sun was also picked up and dropped off in the car that day, and she even asked sun to help, "we'll take care of it. i went to see the lower teeth, and all the good upper teeth were extracted. sun didn't tell me. "on september 21, "my parents said they were going to have their teeth repaired, so i went with them, and then i realized that all the teeth were gone." speaking of this, ms. hu became a little emotional. the 90-year-old man accompanied the 83-year-old man to see the dentist, "doesn't a family member's signature be required for such an old man to undergo surgery? my father was not asked to sign during the whole process. the treatment plan has been decided. , why didn’t the children be notified of the whole process while they were still there? even young people can’t bear to have all their teeth removed at once, let alone an 83-year-old man who has had a heart bypass and has high blood pressure.”

ms. hu recalled that on september 19, her father called her. he did not mention full-mouth tooth extraction or full-mouth dental implants. he only said that he had taken his mother to have her lower teeth done. "we talked on the phone around 7 o'clock that night. they just said go home."

>>83-year-old old lady

the doctor said that after having dentures, i can’t eat for a month, and i can’t see anything and ask for a signature.

on september 25, a reporter from the chinese business daily dafeng news met ms. hu and her parents, mr. hu and ms. lu, at tuanyuan stomatological hospital in xi’an xincheng. ms. lu still has many bruises and bruises on her philtrum and chin, and her upper lip needs help from her hands to push it open. "i dare not touch my mouth because it hurts when i talk." ms. lu said that all the teeth in her mouth had been pulled out. "that day when i came to see my dentist, they told me that i would have to put an iron plate in my mouth to make the removable tooth. if i couldn't eat for a month, i would starve to death. they told me that i could have the tooth implanted the same day and i could eat the next day. my mouth is like a chicken paw, i don’t dare to bite it, and i only drink liquid food these days.”

ms. lu still has many bruises and bruises on her philtrum and chin, and her upper lip needs help from her hands to remove it.

mr. hu said that he and his wife looked at the lower teeth, and found that the two loose teeth were extracted. "every morning there is blood on the pillow." the doctor clearly told him at that time that he would have to wait a month to wear the dentures, and he could not eat without teeth. i only had a quick meal in the afternoon on the day of the dental implant, and i pretended to eat and drink normally the next day, so i agreed to the dental implant. "but i kept bleeding, and it took two days before the tooth was implanted. i can't even eat now. the hospital shouldn't lie to people." it was fine at first, but i felt so dizzy after seeing the tooth that i couldn’t stand.” until this moment, mr. hu didn’t know that his wife’s upper teeth had been extracted again on september 20. later, when reporters and the hospital asked about the treatment process, mr. hu said the husband just learned that his wife’s upper teeth were all gone. “i thought she had braces on her upper teeth. how could she have them all extracted and still get dental implants? let’s look at the lower teeth. the upper teeth are fine. why do we need to extract the upper teeth?” so bold!”

however, when asked how many teeth were extracted, how many upper teeth were there, what brand of implants were used, what materials were used, etc., ms. lu didn’t know at all, “i don’t know what kind of teeth these are, they said my daughter’s (dental implants) ) can be used for 40 years, and this (dental implant) of mine can be used for 60 years.” ms. lu said that after 60 years, she will be over 140 years old and will not need those. , i couldn’t see the small print, so i didn’t know what it was written. ‘write your name here, write your name here, and put your fingerprint here.’ i asked if there were reading glasses for me to wear, but they didn’t say anything and asked me to fill in the words. there are five or six."

after tooth extraction, my mouth was full of blood. i reunited with my mouth and went home to the bank to withdraw money. my 90-year-old wife accompanied me but i didn’t know that all of my wife’s upper teeth had been extracted.

on september 25, the old couple told reporters about their treatment at tuanyuan dental hospital in xi'an xincheng. ms. lu said that on september 19, sun called a car to pick up and take the old couple to the hospital for dental treatment. after pulling out two lower teeth at noon, her mouth was full of blood. she still had to pay 40,000 to 50,000 yuan for dental implants. "xiao sun asked a car to follow me home to pick up the deposit receipt, and then followed me to the bank to withdraw 50,000 yuan. after withdrawing the money, she she kept holding it, and she dragged me to pay the fee when i went back to the hospital. she gave me the remaining 6,000 yuan and paid another 44,000 yuan. "after withdrawing the money, returning to the hospital, and paying the fee, the lower dental implants arrived that day. around 4pm. on september 20, i went to the hospital again to have my upper teeth extracted.

mr. hu always thought that his wife would go for anti-inflammation injections and follow-up treatment in the next few days, but he didn’t know that he had to pull out the upper teeth the next day. “my mouth was full of blood every day, i couldn’t wear the teeth, and the pain was so bad that i couldn’t help it. he said he would have it the next day. i had to wear my teeth while eating, and the bleeding was severe, so i had to wear my teeth for several days.”

asked why he didn’t tell his children? ms. lu said that she had to pay another 40,000 to 50,000 yuan, which was too much money. on the one hand, she was afraid that her children would talk about her, and more importantly, "i don't know this when i am old, so i didn't tell them, and i didn't want to hurt my children." i have to say, the children must give me money. i don’t want to drag them down. i have money and they don’t need to give me money.” at this point, ms. lu cried, “i’m just afraid that i won’t be able to eat.” mr. hu said. they’re all busy, and it’s useless to call them. they say they can’t eat for a month, so what else can they do (move the teeth)?”

the xi'an xincheng tuanyuan dental hospital charge sheet provided by ms. lu shows that the total cost of 12 yading implants is 48,600 yuan.

>>reporter’s unannounced visit

after learning about the treatment process, i was "thrown into a hut". after questioning for 2 hours, i was told that all 6 of the old woman's upper teeth were extracted at one time.

on the afternoon of september 25, a reporter from the chinese business daily dafeng news conducted an unannounced visit to xi'an xincheng tuanyuan dental hospital as a patient's family member to learn about the treatment process that day. the reporter, the patient and their family members were taken to a "hut" outside the tuanyuan dental treatment building. the dean, manager, assistant dean, director and other staff members came forward one after another. when asked about the treatment process, the staff left with excuses. after a while, another person would have said it was irresponsible and unprofessional when asked key questions. he only asked how many upper teeth ms. lu had extracted. the reporter, the patient, and their family members waited for more than two hours before finally getting the answer - 6.

reporters, patients and their families were taken to a "hut" outside the tuanyuan dental treatment building

the staff took out a copy of ms. lu’s oral ct and said,there are six upper teeth in total; two lower teeth are loose, and there are two wisdom teeth. "the wisdom teeth were not extracted, but 6 upper teeth and 2 lower teeth were extracted. 12 dental implants were made, 6 upper and lower teeth." lu on september 19, the lady had 2 lower teeth extracted and 6 lower teeth implanted; on the 20th, 6 upper teeth were extracted and 6 upper teeth implanted.

why extract the upper teeth to see the lower teeth? "generally speaking, if a tooth can be extracted, it must meet the indications for tooth extraction. i don't know about ms. lu's situation." the staff member said.

there is no record of the number of teeth extracted in the medical treatment file, and the reason for tooth extraction is not included in the "informed consent form for tooth extraction surgery"

in the 35-page copy of the medical file provided by xi'an xincheng tuanyuan stomatological hospital, there is no specific record of the number and location of the extracted teeth. in an "informed consent form for tooth extraction surgery" dated september 19, the doctor has informed the patient that the tooth needs to be extracted. the blank space for the cause of the disease was not filled in, and "extract all remaining teeth in the mouth" was handwritten in the blank space. in the medical history item, the history of heart disease was not checked. there was only ms. lu’s signature and fingerprint at the signature area, and the “signature of the trustee/legal guardian” was blank and unsigned.

on august 22, on the oral facial consultation record sheet, the initial oral consultation plan was: extraction of mandibular implants or adsorbent prosthesis, and a large maxillary brace. in the medical record on september 19, the treatment plan changed to: full mouth implant repair. the patient gave informed consent. considering the patient's age and physical strength, the upper half of the mouth and the lower half of the mouth were implanted separately. the medical records on september 19 and 20 both mentioned that "the patient and his family members have informed understanding and requested treatment", and the signature was signed by a doctor. the medical records on the 21st showed that the gum protective cap was removed and inserted into the upper and lower jaw to fix the teeth in stages.

staff: immediate dental implants are not implanted on the spot, but the transitional teeth are called "immediate teeth"

the staff said that ms. lu is now wearing temporary teeth. "it's too late to adjust it. it's not finished yet. the temporary teeth that are installed now are just for you to eat. if they are damaged, they will be repaired."

ms. lu’s procedure was immediate extraction and implantation. wasn’t the “immediate implantation” done on the spot? she said that the transitional teeth that ms. lu is currently installing are called "immediate teeth." it is a new technology. it takes half a year before the abutment and crown can be installed. "no matter how big or small, this is an operation, and it will bleed, and it will take a long time." "she said that the recovery period was normal and her mouth was not working properly. "it's just that the new teeth are not used to it and they need to adapt. some people wear transitional teeth for several months."

regarding the question of why an 83-year-old heart disease patient had all her teeth removed and implanted and changed her treatment plan without informing her children, the staff said, "there will definitely be an evaluation before the dental treatment. her physical condition is sufficient. she does not have alzheimer's disease and her thinking is very clear." ”

another staff member said that the hospital will not notify family members during the operation, let alone the children. “there is no such law.” she said that her family members were not required to sign when she was present, and ms. lu was accompanied by family members. “the law does not say my wife can’t accompany me.”

the old man was in unbearable pain, and the medical director said, "you look very energetic."

the staff said that sun was a hospital staff member. why go with the old man to withdraw money? "that's how they work in the market. the elderly are getting older. if they need to be accompanied, they can just follow." in this regard, the family members questioned that they knew that they were getting older when withdrawing money. why didn't they inform them of the alternative plan for tooth extraction and implantation? "i won't tell you this until the market people come."

while waiting, ms. lu expressed her mouth pain and dizziness many times, showing an expression of pain. when she couldn't bear it, she lay down at the table. a medical director came in and measured the blood pressure, which was 152 for high pressure and 74 for low pressure. the staff asked, "if she drinks porridge every day, will she not feel dizzy?" the medical director told ms. lu: "you have to eat nutritious food, and you will be more energetic."

when asked how many teeth had been extracted in total, they did not tell them. they said they could go to the assistant dean named zhao, and only she knew the specific treatment plan.

why didn’t the hospital notify the family if the planned surgery was changed? assistant to the director surnamed zhao: the patient communicates with his family members themselves

after waiting, sun and the assistant dean named zhao came in. the assistant to the dean named zhao said that considering the old man’s age, he had her lower teeth done on the first day and allowed her to go back to rest, and the upper teeth were done on the second day. “after the treatment was done, i came here for injections every day, and (ms. lu) was in great condition. "

why didn't the family inform me when they proposed changing the treatment plan? "i would definitely not want to tell the girl." assistant to the dean surnamed zhao said that sun went to the community again on september 24. ms. lu met her and gave sun fruit and meat. "everything is fine. now i am not feeling well. you can go to a general hospital to register with the internal medicine department. this is a specialized hospital and you can only do dental treatment, which is not the right specialty.”

the assistant to the dean named zhao insisted that "there is no change of plan." it was ms. lu who wanted dental implants herself and was afraid of the one-month adaptation period for removable teeth. "we talked about the adaptation period, and we didn't say that she couldn't eat."

the patient’s family members and children were not informed of the tooth extraction and dental implant surgeries because “the aunt (referring to ms. lu) said that she would spend her own money, and when she told the woman, she thought she was asking her children for money.” she said that the patient should contact his family and inform them, “here you are ( refers to the patient) time, you should communicate with the family yourself. "

dental implants cost an extra 44,000 yuan. the market manager of tuanyuan dental asked the elderly to pick up the money and then return to the hospital for dental implants.

the reporter saw that sun's work badge showed as "marketing manager." sun said that two plans were proposed and the plan was indeed changed. at that time, mr. hu said that he called his daughter.

when the reporter asked about withdrawing money from his home or bank, the assistant to the dean named zhao immediately called sun to get some water. after coming back, he asked about the process of withdrawing the money. sun looked at the assistant dean named zhao and said, "no, i gave it to my aunt when i needed the money. i can't remember when i picked it up and when i left."

finally, a medical director came forward. after a face-to-face confrontation with ms. lu, sun admitted that on september 19, after ms. lu had her lower teeth extracted, she followed ms. lu to her home to get the deposit certificate and went to the bank to withdraw money. , the reason is that "the elderly need to be taken care of as they get older", "i have the money, and i don't take it away."

the medical director said that ms. lu's vital signs are currently normal and her recovery is going through a process. "there is no problem until the 19th. the old man couldn't accept the process of making removable teeth, so he got the dental implant." see why the lower teeth need to be extracted. lower teeth? "all teeth must be evaluated by a doctor," she said.

>>xincheng district health bureau

tuanyuan dental hospital receives complaints every month. whether the patient’s signature is valid or not depends on the law.

on september 26, reporter dafeng news from huashang daily and ms. hu came to the medical affairs section of xi’an xincheng district health bureau. the staff said that they often receive complaints about tuanyuan dental hospital every month.

after ms. hu reported the situation, the staff said that there was no clear requirement for family members to accompany her. “you (the patient) did sign.” she said that determining whether the patient’s signature on the medical record is valid must be based on the law. “we will obtain information, etc. we will conduct an investigation. the child did not sign. we cannot define this. it depends on whether the patient who signed has the capacity for civil conduct. there is no law that prohibits signing if the patient is over 80 years old. this is an oral surgery, not a major surgery, and it is not a tertiary hospital." he said that it is indeed unreasonable not to inform the children, but it must be investigated first.

went to see the lower teeth but the upper teeth that could be used normally were extracted? staff said this needs to be determined in conjunction with the hospital's plan.

"xi'an huamei medical cosmetology hospital" appeared in the dental implant file, and the staff said that huamei did not have the qualifications for dental implants

in the "case continuation page" of ms. lu's dental implant, multiple signs such as "yading tools", "surgical instruments" and "auxiliary material packages" show that the department is dental and the unit is "xi'an huamei medical cosmetology hospital". ms. hu asked, why did you change the hospital for dental implants? on september 25, the staff of tuanyuan dental said, "our two families are one family."

so, what is the relationship between the two hospitals? is the practice of mixed medical practice legal? the staff said that tuanyuan dental is a secondary medical institution, and huamei’s medical aesthetics is not classified, and huamei does not have the qualification for dental implants. ""they don't have this project, and i don't know the details. when we inspected the disinfection before, the two hospitals were doing it together. the details need to be explained by the hospital. the problem of confusion in medical practice has not yet been identified. we are not law enforcement officers. we need to wait for verification by relevant departments before handling the matter. we cannot make a conclusion now and need to investigate and confirm. "

the health department will conduct an investigation and family members are advised to negotiate with the hospital first.

the staff contacted the person in charge of xi'an xincheng tuanyuan dental hospital on site to come to the district health and health bureau. tuanyuan dental staff said that operations such as tooth extraction were communicated with the elderly, but they also admitted that they did not inform the elderly about the extraction of their children’s teeth. “we all pull out teeth in this way, and some of them pull out more than a dozen teeth at a time, mainly the stumps.” ms. hu asking back, are the upper teeth also stubs? the person in charge did not answer.

after both parties understood the situation, the staff of the district health bureau asked xi'an xincheng tuanyuan stomatological hospital to seal patient files such as medical records. "law enforcement officers need to check whether the diagnosis and treatment process is standardized, including considering the patient's age and preoperative diagnosis to determine whether the tooth can be extracted. at present, if the patient has adverse reactions after surgery, the hospital should follow up in a timely manner to ensure the safety of the elderly. at the same time, diagnosis and treatment should be combined data verification." the staff suggested that the patient consult with tuanyuan dental hospital first, and then contact the family member, ms. hu, after the investigation results are available.

the person in charge of tuanyuan dental said that if the physical discomfort caused by the elderly is caused by dental implants and there is a diagnosis certificate from another hospital, they will bear the corresponding responsibility.

>>planting experts

the main problem lies in the maxillary extraction and implantation. caution must be exercised in elderly patients.

on september 26, a reporter from the chinese business daily dafeng news contacted a dental implant expert from a top-level hospital in xi’an. based on ms. lu's medical records and x-rays, he said: "the lower jaw teeth were implanted and the patient had a heart disease. if pre-operative evaluations were carried out, there would be no major problems with the lower jaw."

as for ms. lu's upper jaw, the expert said that it is generally like middle-to-late stage teeth. if the teeth cannot be retained, the patient will be given dental implants. "some teeth cannot be retained, and if the elderly are willing to do so, they will consider tooth extraction and implant restoration. however, removable dentures can also be repaired. in terms of stability, removable dentures are definitely not as effective as implants." he said, according to in ms. lu's case, in addition to communication problems, there are also indications for surgery. "elderly people and children may not have thought that the postoperative reaction would be so severe if the upper jaw was removed and implanted at once. for older patients, we are more cautious.”

>>lawyer’s statement

if the hospital fails to fulfill its obligation to inform and explain and the elderly person signs the surgical documents, the right to know will be violated.

zhao liangshan, senior partner of shaanxi hengda law firm and a well-known public interest lawyer, believes that the reasonableness of the tooth extraction and dental implant operations performed by the hospital involved depends on whether the hospital clearly informed the patient and whether the patient consented. article 32 of the "basic medical care and health promotion law of the people's republic of china" clearly stipulates that citizens who receive medical and health services have the right to informed consent in accordance with the law regarding their condition, diagnosis and treatment plans, medical risks, medical expenses and other matters. in this incident, if the hospital involved failed to fulfill its obligations of notification and explanation and the elderly person signed the relevant surgical documents, the elderly person's right to know would have been violated.

zhao liangshan said that the old man mentioned that he was old and could not see many words clearly, so it was obviously unreasonable to be asked to sign directly. according to article 1219 of the "civil code", medical personnel must not sign during diagnosis and treatment activities. the condition and medical measures should be explained to the patient. if surgery, special examinations, or special treatments are required, medical staff should promptly explain the medical risks, alternative medical plans, etc. to the patients in detail, and obtain their explicit consent. this means that medical institutions can only carry out diagnosis and treatment activities with the elderly’s “explicit consent”. because the elderly person cannot see the content clearly and does not fully understand the content of the signature, such a signature should not be regarded as the elderly person's "explicit consent". if the patient's right to know and consent are violated, the hospital involved is suspected of violating the law.

dental implant surgery for the elderly carries high risks, and it is more reasonable to obtain family consent

zhao liangshan pointed out that regarding the change of treatment plan, the two parties signed a contract by paying fees, which means that both parties have confirmed and agreed on the treatment method to be adopted. if the hospital proposes other dental implant plans, it is a major change to the original contract. whether such a change is legal or not depends on whether the patient's consent has been obtained and whether it has been fully explained and informed. as the elderly person involved is older, this obligation to inform and explain becomes even more important. apparently, the old lady mentioned "if you can't see it, just sign where you want" when signing, which may indicate that the hospital is deficient in protecting patients' rights to know and choose. however, if the hospital can prove that it has fully fulfilled its relevant obligations and the elderly person's behavioral abilities are normal, this change will be legally effective. but relatively speaking, the elderly are older and have higher risks of dental implant surgery, so it is more reasonable to obtain the consent of their family members.

the safety of pulling out seeds within two days is questionable, and you can entrust a professional organization to evaluate it.

zhao liangshan said that if the hospital's medical practice of extracting multiple dental implants within two days did not conduct a medical evaluation and risk assessment, it would violate medical operating standards and safety requirements. because the old man involved was old and had underlying diseases, and the hospital did not have any evidence to show whether a physical examination was performed on the old man or whether any assessment of the old man’s underlying diseases was carried out, the safety of tooth extraction was questionable. the feasibility of dental implants is doubtful. if the hospital does not have sufficient evidence to prove it, then such behavior of extracting teeth and implanting them in a short period of time violates medical and legal regulations. of course, if the dispute between the two parties is serious, a professional organization can also be entrusted to conduct a risk and feasibility assessment of such short-term diagnosis and treatment operations, and finally provide a neutral assessment plan.

accompanying an old lady to withdraw money violates consumers’ right to financial freedom and independent choice.

zhao liangshan explained that the behavior of hospital marketing personnel accompanying patients to keep money is obviously inappropriate, because as a diagnosis and treatment institution, the hospital’s mission is to admit patients, complete diagnosis and treatment, and collect corresponding fees for diagnosis and treatment. such diagnosis and treatment should be limited to necessity. the marketer involved should be one of the hospital staff, and his marketing behavior has exceeded the scope of normal diagnosis and treatment. in order to achieve the purpose, he accompanied the old lady to withdraw money, infringing on consumers' financial freedom and independent choice rights, because they accompanied or helped to withdraw money, etc. behavior will directly affect the elderly's judgment.

the two hospitals are legally independent entities, and chaotic management is illegal.

zhao liangshan said that regarding the issue of confusion between institutions, this is also not allowed by law. dental implants are diagnostic and therapeutic activities. because they are performed in the oral cavity, the requirements are relatively high. dental implant medical institutions need to have medical institution practice licenses, professional department settings, doctor qualifications, equipment environment and disinfection standards, and complete implant materials. failure in any one of them may lead to infection or surgical risks. the staff of the two hospitals involved mentioned that they are the same hospital, which is obviously untenable because the same internal shareholding or overlap in management does not mean that the legal personalities of the two hospitals are mixed. the two hospitals are legally independent individuals bear their own legal consequences, so if a patient visits one of the institutions, it is obviously illegal for another medical institution to participate in the diagnosis and treatment. therefore, the management of the two institutions is chaotic and illegal.

zhao liangshan finally said that regarding the levels of two hospitals, this is usually assessed by the health administration department based on the hospital's size, facilities, technology, staffing and other factors. whether they have medical qualifications can be verified through the health administrative department, because medical diagnosis and treatment falls within the scope of administrative approval, and relevant certificates need to be filed.

chinese business daily dafeng news reporter she xin/written by deng xiaowei/photo intern wang xinyue